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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

US is becoming a widely used diagnostic and therapeutic tool in emergency medicine training and practice. Its use in detecting an AAA is efficient and practical and can occur concurrently with resuscitation. US of the abdominal aorta has been shown to be highly accurate for the detection of AAA and to decrease the time to operative repair of ruptured AAA. The emergency physician should consider using US to search for an AAA in any patient presenting with abdominal or back pain or with shock of unknown etiology.
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PMID:Ultrasound detection of abdominal aortic aneurysm. 1530 45

Background. The optimum timing of surgery for acutely symptomatic abdominal aortic aneurysm (AAA) remains a clinical dilemma: should symptomatic aneurysm be operated on urgently for fear of impending rupture, or should there be a period of preoperative evaluation to optimise the patient's medical co-morbidity, with a consequent delay in surgery? Method. Ninety-five patients were diagnosed with acutely symptomatic AAA (back pain, abdominal pain or a tender aneurysmal aorta) between 1995 and 2001 and included in a retrospective case-cohort study. The in-hospital mortality rates for patients undergoing early surgery (within 24h of presentation) were compared to those of patients whose surgery had been delayed to allow further evaluation. Results. Of 95 patients with an acutely symptomatic AAA, 70 had surgery within 24h of admission. The remaining 25 underwent planned delayed surgery after a median of (range) three (2-17) days. The reasons for delay to AAA repair were primarily to allow further cardiorespiratory assessment and radiological imaging. In the early surgery group, there were six postoperative deaths (9%); in the group who were to have delayed surgery, there were three (12%) deaths (P=0.694). Conclusion. Early operation for acutely symptomatic AAA, in selected patients, is not associated with an excessive mortality rate compared to delayed operation.
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PMID:Does immediate operation for symptomatic non-ruptured abdominal aortic aneurysm compromise outcome? 1546 77

Development of endoleak after conventional open repair of abdominal aortic aneurysm is less well documented compared with endovascular stenting. We present a case report of a 65-year-old man who had sudden onset of back pain with central abdominal tenderness 34 days after successful open repair of an abdominal aortic aneurysm. Urgent laparotomy revealed the presence of a noninfective intrasac hemorrhage, due to recanalization of the lumbar arteries. These were successfully suture ligated. Delayed lumbar hemorrhage should be an important differential diagnosis by frontline medical personnel in patients with recent open aneurysm repair. The recent literature on other causes and management strategies is also reviewed.
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PMID:Late lumbar hemorrhage after open repair of abdominal aortic aneurysm: computed tomographic appearance resembling type II endoleak. 1555 25

Primary aortoenteric fistulas (PAEF) are rare entities associated with a high mortality. Although several causes have been reported, their occurrence is usually due to erosion of an abdominal aortic aneurysm into the intestinal tract. The most common sites for the fistula are the third and fourth portions of duodenum. The classical triad of gastrointestinal hemorrhage, abdominal mass and abdominal or back pain, though highly suggestive for PAEF, is uncommon. The typical bleeding pattern associated with PAEF is characteristically intermittent, starting with a brief "herald bleeding" followed eventually by major gastrointestinal hemorrhage, often with fatal outcome. The pre-operative examinations are often not helpful and can lead to delayed diagnosis and surgery. In a patient with risk factors for atherosclerosis and significant upper gastrointestinal bleeding in the absence of an evident source, PAEF should be suspected. A high index of suspicion of this condition allows correct diagnosis and definitive treatment to be carried out. If PAEF is suspected and the patient is unstable the surgeon should be prepared to skip the preoperative investigations in favour of early surgical exploration. Definitive treatment includes primary duodenal repair and aortic aneurismal resection with graft "in situ" replacement. The authors present a successfully treated case and stress the importance of clinical suspicion in order to achieve correct diagnosis and treatment.
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PMID:[Primary aortoenteric fistula. Report of a case]. 1560 30

Acute spontaneous arterio-venous fistula complicating atherosclerotic abdominal aortic aneurysm (AAA) is rare. This life-threatening setting is observed in 1-2% of all AAAs and 2-4% of ruptured of AAAs. The triad of abdominal or lower back pain, pulsatile abdominal mass, and continual abdominal machinery-like bruit is seen only in half of cases. Currently, CT angiography is a noninvasive technique which enables a rapid and exact preoperative diagnosis. The authors describe three cases of aortoiliac aneurysm complicated by an acute arteriovenous fistula which were diagnosed using spiral CT.
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PMID:[Diagnosis of spontaneous arteriovenous fistula complicating aortoiliac aneurysm using spiral CT. Report of 3 cases]. 1566 95

A case of right renal artery distal aneurysm associated with juxtarenal abdominal aortic aneurysm in a 75-year-old male, who presented with abdominal and back pain and chronic renal failure, is reported. The abdominal aortic aneurysm was repaired with a bifurcated Dacron graft. The right kidney was simultaneously explanted, ex vivo reconstruction of the renal artery with PTFE graft was performed, followed by autotransplantation of the kidney into the right iliac fossa. In the postoperative course the renal function returned to normal.
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PMID:Ex vivo repair of renal artery aneurysm associated with repairing of abdominal aortic aneurysm. Case report. 1587 8

The role of endovascular therapy in the management of inflammatory aneurysms of the infrarenal abdominal aorta has been controversial. Review of our endovascular database identified six patients who have undergone treatment for preoperatively diagnosed inflammatory abdominal aortic aneurysms. Outcomes measured were primary success of the procedure, variation in computed tomographic (CT) scan-defined perianeurysmal fibrosis, change in aneurysm size, development of endoleak, requirement of reintervention, aneurysm rupture, and progression or resolution of symptoms. At a median follow-up of 20 months (range 4-56 months), endovascular repair has been successful in all six patients. All patients demonstrated CT reduction of perianeurysmal fibrosis, with a median of 47% absolute reduction (range 33-69%, p = 0.014). All patients had aneurysm sac shrinkage, with a mean of 41% (range 6-86%, p = 0.04). There were no aneurysm ruptures or persistent endoleaks. Of the three patients who presented with abdominal or back pain, all are now symptom-free. One patient required reintervention for limb thrombosis of a bifurcated graft after 2 years. In conclusion, endovascular treatment of an inflammatory abdominal aortic aneurysm is safe and effective and the treatment of choice in anatomically suitable patients.
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PMID:Midterm follow-up of inflammatory abdominal aortic aneurysms following endovascular repair. 1602 97

Abdominal aortic aneurysm (AAA) is one of the important differential diagnoses of back pain which is often missed. Chronic contained rupture is a rare event that can cause diagnostic difficulties, presenting in different ways such as back pain, neuropathy or groin mass. We are presenting a case of 46-year-old man who presented with history of recurrent low back pain radiating to his left leg, associated with sensory deficit in the left thigh. His complaint proved to be resulting from chronic contained AAA leak.
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PMID:Chronic contained rupture of abdominal aortic aneurysm presenting with longstanding back pain. 1616 99

Most adults in the United States will experience an episode of back pain at some point during their lifetime. Most will present to their primary care physician for evaluation and treatment. Many patients have non-life-threatening etiologies and recover within 4 to 6 weeks. A small percentage, however, have back pain due to a potentially life-threatening emergency. AD,rupturing AAA, SEM, cauda equina syndrome, vertebral osteomyelitis,and SEA are just some of the medical emergencies that can present with back pain. Clinical suspicion for these diagnoses begins with a thorough history and physical examination. It is imperative that the office-based physician search for and accurately identify any red flag within the history or physical examination. Appropriate laboratory studies and diagnostic imaging are obtained based on the suspected etiology.
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PMID:Back pain emergencies. 1647 2

We report a case of combined colon cancer and Clostridium septicum aortitis involving the suprarenal abdominal aorta with rupture. An 82-year-old male presented with fever, abdominal pain, and back pain associated with constipation. He was successfully treated by in situ aortic graft placement with polytetrafluroethylene and concomitant colon resection. Only 20 other cases of C. septicum mycotic aneurysm, aortitis, or aortic dissection have been reported. Concomitant surgical treatment for Clostridium aortitis or mycotic abdominal aortic aneurysm and colon cancer can be accomplished successfully in selected cases when the diagnosis of both conditions is made preoperatively.
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PMID:Suprarenal Clostridium septicum aortitis with rupture and simultaneous colon cancer. 1677 91


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